More Research Shows Yoga Quality-of-Life Benefits for Paroxysmal AF

Deborah Brauser

March 15, 2016

STOCKHOLM, SWEDEN — A new study is contributing to the mantra that yoga can improve quality of life (QOL), as well as decrease heart rate in patients with paroxysmal atrial fibrillation (PAF)[1].

The randomized pilot trial of 80 AF patients in Sweden showed that those who received standard therapy and participated in a 12-week yoga program, designed specifically for CVD patients and focused on deep breathing, plus standard therapy, had significantly higher mental-health scores vs those who received standard therapy only. The yoga group also had significantly lower heart rate and lower systolic and diastolic blood pressure (BP).

Although small in number, "to our knowledge this is one of the largest randomized studies evaluating the effect of yoga in patients with PAF," note the investigators, led by Maria Wahlstrom (Karolinska Institutet, Stockholm, Sweden).

"Our results show that yoga significantly improves QOL and that their increased comfort allows them to more easily tolerate their conditions," they write, adding that lowering BP and heart rate may also "give patients a feeling of security."

Based on the findings, "yoga could be a complementary treatment method to standard therapy," write the researchers.

The findings were published online March 14, 2016 in the European Journal of Cardiovascular Nursing.

Therapeutic Yoga

As reported by heartwire from Medscape, past research has shown that forms of yoga can lower BP as well as other CV risk factors.

The current investigators wanted to assess possible yoga benefits specifically in PAF patients, "who experience deterioration in health-related quality of life compared with the general population and patients with other cardiovascular diseases," they write. "This may potentially increase mortality, morbidity, and hospitalization."

In the single-center study, half of the participants were randomly assigned to receive standard therapy alone (control group) and the other half were assigned to standard therapy plus Mediyoga, a "therapeutic form of yoga evolved from Kundalini," report the investigators.

The yoga group sat on chairs in a weekly class and, as instructed by a trained teacher, did deep breathing exercises, meditation, and light movements designed to stretch chest muscles and relax the body. They were also given CDs and written instructions and told to continue the practice at home.

Standard treatment included "medication, cardioversion, and catheter ablations."

Measures, including BP and heart rate, were assessed at baseline and 2 weeks after the 12-week treatment period ended. QOL was measured using the EuroQOL (EQ-5D) Visual Analog Scale (VAS) and the 36-question Short-Form Health Survey (SF-36). For both QOL questionnaires, a score of 100 was the highest and best available.

Alternative Medicine

At baseline, the yoga group had a significantly lower SF-36 mental-health score vs the control group (mean 42.1 vs 53.0; P<0.001); but their score improved significantly at follow-up (50.6, P<0.001), whereas the scores for the control group did not (between group, P=0.02).

The EQ-5D scores were also significantly lower for the yoga group at baseline (70 vs 80 for the control group, P=0.03) and then improved significantly at follow-up (80, P<0.001). However, their final score was not significantly different from the control group.

There were also no significant between-group differences for scores on the SF-36 physiological health scale at any time point.

The heart rate, however, was significantly lower for the yoga group at follow-up (P=0.02), as were systolic BP (P=0.03) and diastolic BP (P<0.001) vs the control group.

"To handle the emotional consequences that come with atrial fibrillation, patients need practical tools," write the investigators. "It is becoming more common for patients with arrhythmia to use complementary alternative medicine, including yoga."

Still, they note that more research is needed, especially in a bigger group of participants, and that it should compare yoga with other interventions, such as relaxation techniques.

The study was supported by the Karolinska Institutet. The study authors report no relevant financial relationships.

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